Objective: To evaluate the effects of combined periodontal-orthodontic treatment on aesthetics and periodontal function in patients with malocclusion and periodontitis. Methods: Eighty patients treated from March 2022 to March 2023 were randomly assigned to a control group (n=40) or a study group (n=40). The control group received basic periodontal therapy, while the study group received straight-wire orthodontic treatment plus basic periodontal therapy. Outcomes included periodontal inflammation, aesthetic scores, periodontal health indices, and gingival crevicular fluid osteocalcin levels.Results: One month after treatment, the levels of periodontal C-reactive protein, interleukin-6, and tumor necrosis factor-α in the study group were (7.32±1.17) mg/L, (13.56±2.15) pg/mL, and (25.06±4.07) pg/mL, respectively, which were lower than those in the control group [(8.79±1.56) mg/L, (15.95±2.29) pg/mL, and (29.15±4.21) pg/mL] (t =4.768,4.812,4.417,P<0.05). One month after treatment, the PES and WES scores in the study group were (10.68±1.58) points and (8.36±0.65) points, respectively, which were higher than those in the control group [(9.09±1.72) points and (7.54±0.58) points] (t =4.306,5.953,P<0.05). One month after treatment, the gingival, bleeding, and plaque index scores in the study group were (0.76±0.13) points, (0.68±0.12) points, and (0.84±0.16) points, respectively, which were lower than those in the control group [(1.02±0.15) points, (0.87±0.17) points, and (1.21±0.22) points] (t =8.284,5.775,8.602,P<0.05). One month after treatment, the osteocalcin level in gingival crevicular fluid in the study group was (415.76±52.13) points, which was higher than that in the control group [(382.02±48.15) points] (t =3.007,P<0.05). Conclusion: Combined periodontal-orthodontic treatment improves periodontal health, reduces inflammation, increases osteocalcin levels, and enhances aesthetics, demonstrating significant clinical value.